Preoperative Spirometry to Predict Postoperative Complications in Thoracic Surgery Patients
ANAKAPONG PHUNMANEE, M.D.*, CHERDCHAI TUNTISIRIN, M.D.**, URAIW AN ZAEOUE, M.Sc. in Nursing.*
Affiliation : * Division of Pulmonary and Critical Care Medicine, Department of Medicine, ** Division of Cardiovascular and Thoracic Surgery, Department of Surgery, Faculty of Medicine. Khon Kaen University, Khon Kaen 40002 Thailand.
Spirometry is a simple and basic test that can provide more information about pulmonary
function. Many thoracic surgeons do a spirometry test to assess the pulmonary status of their
patients before surgery.
Objective : To determine if preoperative spirometry can predict postoperative compli-
cations following thoracic surgery.
Design : Retrospective case control study.
Setting : Srinagarind Hospital Medical School, Khon Kaen University, Khon Kaen Thailand.
Participants : Adult patients who had spirometry before thoracic surgery.
Measurement and
Results : From 1995 to 1998, we reviewed thoracic surgery patients
who had spirometry testing before thoracic surgery. Fifty-six patients were enrolled in our
study. Postoperative complications of these patients were determined by a systemic extraction of
medical record data. The postoperative complications were classified into two groups, respira-
tory and non-respiratory complications. Eighteen patients experienced at least one respiratory
and other complications. There was a sixfold or greater increase in non-respiratory compli-
cations (cardiac arrhythmia, congestive heart failure, prolonged hospital stay, upper gastrointestinal
bleeding and wound infection), which were associated with moderate and severe impairment of
FEY1 and FVC (<66%predicted) (p<0.05). There was a thirty percent increase in non-respiratory
complications, which were associated with FEY 1 < 2 liters (p<0.05), FEV 1 or FVC less than 70
per cent of predicted value (p<0.05). No spirometric values were a good predictor of respiratory
complications.
Conclusion : Preoperative spirometry levels in patients requmng thoracic surgery of
FEY 1 < 2 liters, FEY 1 or FVC <70 per cent of predicted value was associated with postoperative
complications, especially non-respiratory complications.
Abbreviation: FEY1 =Forced expiratory volume in one second, FVC =Forced expiratory capacity
Keywords : Preoperative Prediction, Spirometry, Postoperative Complication, Thoracic Surgery
